Born Toward Dying

This essay by Richard John Neuhaus was originally published in the February 2000 issue of First Things .

We are born to die. Not that death is the purpose of our being born, but we are born toward death, and in each of our lives the work of dying is already underway. The work of dying well is, in largest part, the work of living well. Most of us are at ease in discussing what makes for a good life, but we typically become tongue-tied and nervous when the discussion turns to a good death. As children of a culture radically, even religiously, devoted to youth and health, many find it incomprehensible, indeed offensive, that the word “good” should in any way be associated with death. Death, it is thought, is an unmitigated evil, the very antithesis of all that is good.

Death is to be warded off by exercise, by healthy habits, by medical advances. What cannot be halted can be delayed, and what cannot forever be delayed can be denied. But all our progress and all our protest notwithstanding, the mortality rate holds steady at 100 percent.

Death is the most everyday of everyday things. It is not simply that thousands of people die every day, that thousands will die this day, although that too is true. Death is the warp and woof of existence in the ordinary, the quotidian, the way things are. It is the horizon against which we get up in the morning and go to bed at night, and the next morning we awake to find the horizon has drawn closer. From the twelfth-century Enchiridion Leonis comes the nighttime prayer of children of all ages: “Now I lay me down to sleep, I pray thee Lord my soul to keep; if I should die before I wake, I pray thee Lord my soul to take.” Every going to sleep is a little death, a rehearsal for the real thing.

Such is the generality, the warp and woof of everyday existence with which the wise have learned to live. But then our wisdom is shattered, not by a sudden awareness of the generality but by the singularity of a death¯by the death of someone we love with a love inseparable from life. Or it is shattered by the imminent prospect of our own dying. With the cultivated complacency of the mass murderer that he was, Josef Stalin observed, “One death is a tragedy; a million deaths is a statistic.” The generality is a buffer against both guilt and sorrow. It is death in the singular that shatters all we thought we knew about death. It is death in the singular that turns the problem of death into the catastrophe of death. Thus the lamentation of Dietrich von Hildebrand: “I am filled with disgust and emptiness over the rhythm of everyday life that goes relentlessly on¯as though nothing had changed, as though I had not lost my precious beloved!”

It used to be said that the Victorians of the nineteenth century talked incessantly about death but were silent about sex, whereas today we talk incessantly about sex and are silent about death. In 1973, Ernest Becker’s The Denial of Death contended that Freud had gotten it exactly backwards. It is not true, said Becker, that our fear of death is rooted in our denial of sex, but, rather, that our fear of sex is rooted in our denial of death. Throughout history, and in many cultures, sex and death have been engaged in a danse macabre , and not simply at the shadowed margins of erotic fantasy where dwell the likes of the Marquis de Sade.

In sex and death are joined beginning and ending, the generative and the destructive. In today’s culture we chatter incessantly about both sex and death. They are subjected to the specialization of experts, of therapists, ethicists, and the like. Sex and death have been “problematized,” and problems are to be “solved” by sexual technique and the technology of dying. Victorian reticence about sex and our former reticence about death may have mystified both, although the probable intent was simply to put them out of mind. In any event, we have now embarked with a vengeance upon a course of demystification. Now there is nothing we cannot talk about in polite company. It is a great liberation. And a great loss, if in fact both sex and death partake of mystery. Mystery is attended by a fitting reticence.

Death and dying has become a strangely popular topic. “Support groups” for the bereaved crop up all over. How to “cope” with dying is a regular on television talk shows. It no doubt has something to do with the growing number of old people in the population. “So many more people seem to die these days,” remarked my elderly aunt as she looked over the obituary columns in the local daily. Obituaries routinely include medical details once thought to be the private business of the family. Every evening without fail, at least in our cities, the television news carries a “sob shot” of relatives who have lost someone in an accident or crime. “And how did you feel when you saw she was dead?” The intrusiveness is shameless, and taboos once broken are hard to put back together again.

Evelyn Waugh’s The Loved One brilliantly satirized and Jessica Mitford’s The American Way of Death brutally savaged the death industry of commercial exploitation. Years later it may be time for a similarly critical look at the psychological death industry that got underway in 1969 when Elizabeth Kübler-Ross set forth her five stages of grieving¯denial, anger, bargaining, depression, and acceptance. No doubt many people feel they have been helped by formal and informal therapies for bereavement and, if they feel they have been helped, they probably have been helped in some way that is not unimportant. Just being able to get through the day without cracking up is no little thing. But neither, one may suggest, is it the most important thing. I have listened to people who speak with studied, almost clinical, detail about where they are in their trek through the five stages. Death and bereavement are “processed.” There are hundreds of self-help books on how to cope with death in order to get on with life. This essay is not of that genre.

A measure of reticence and silence is in order. There is a time simply to be present to death¯whether one’s own or that of others¯without any felt urgencies about doing something about it or getting over it. The Preacher had it right: “For everything there is a season, and a time for every matter under heaven: a time to be born, and a time to die . . . a time to mourn, and a time to dance.” The time of mourning should be given its due. One may be permitted to wonder about the wisdom of contemporary funeral rites that hurry to the dancing, displacing sorrow with the determined affirmation of resurrection hope, supplying a ready answer to a question that has not been given time to understand itself. One may even long for the Dies Irae , the sequence at the old Requiem Mass. Dies irae, dies illa / Solvet saeclum in favilla / Teste David cum Sibylla : “Day of wrath and terror looming / Heaven and earth to ash consuming / Seer’s and Psalmist’s true foredooming.”

The worst thing is not the sorrow or the loss or the heartbreak. Worse is to be encountered by death and not to be changed by the encounter. There are pills we can take to get through the experience, but the danger is that we then do not go through the experience but around it. Traditions of wisdom encourage us to stay with death a while. Among observant Jews, for instance, those closest to the deceased observe shiva for seven days following the death. During shiva one does not work, bathe, put on shoes, engage in intercourse, read Torah, or have his hair cut. The mourners are to behave as though they themselves had died. The first response to death is to give inconsolable grief its due. Such grief is assimilated during the seven days of shiva, and then tempered by a month of more moderate mourning. After a year all mourning is set aside, except for the praying of kaddish, the prayer for the dead, on the anniversary of the death.

In The Blood of the Lamb , Peter de Vries calls us to “the recognition of how long, how very long, is the mourners’ bench upon which we sit, arms linked in undeluded friendship¯all of us, brief links ourselves, in the eternal pity.” From the pity we may hope that wisdom has been distilled, a wisdom from which we can benefit when we take our place on the mourners’ bench. Philosophy means the love of wisdom, and so some may look to philosophers in their time of loss and aloneness. George Santayana wrote, “A good way of testing the caliber of a philosophy is to ask what it thinks of death.” What does it tell us that modern philosophy has had relatively little to say about death? Ludwig Wittgenstein wrote, “What can be said at all can be said clearly; and whereof one cannot speak thereof one must be silent.” There is undoubtedly wisdom in such reticence that stands in refreshing contrast to a popular culture sated by therapeutic chatter. But those who sit, arms linked in undeluded friendship, cannot help but ask and wonder.

All philosophy begins in wonder, said the ancients. With exceptions, contemporary philosophy stops at wonder. We are told: don’t ask, don’t wonder, about what you cannot know for sure. But the most important things of everyday life we cannot know for sure. We cannot know them beyond all possibility of their turning out to be false. We order our loves and loyalties, we invest our years with meaning and our death with hope, not knowing for sure, beyond all reasonable doubt, whether we might not have gotten it wrong. What we need is a philosophy that enables us to speak truly, if not clearly, a wisdom that does not eliminate but comprehends our doubt.

A long time ago, when I was a young pastor in a very black and very poor inner-city parish that could not pay a salary, I worked part-time as chaplain at Kings County Hospital in Brooklyn. With more than three thousand beds, Kings County boasted then of being the largest medical center in the world. It seems primitive now, but thirty-five years ago not much of a fuss was made about those who were beyond reasonable hope of recovery. They were almost all poor people, and this was before Medicare or Medicaid, so it was, as we used to say, a charity hospital. They were sedated, and food was brought for those who could eat. The dying, male and female, had their beds lined up side by side in a huge ward, fifty to a hundred of them at any given time. On hot summer days and without air-conditioning, they would fitfully toss off sheets and undergarments. The scene of naked and half-naked bodies groaning and writhing was reminiscent of Dante’s Purgatorio .

Hardly a twenty-four-hour stint would go by without my accompanying two or three or more people to their death. One such death is indelibly printed upon my memory. His name was Albert, a man of about seventy and (I don’t know why it sticks in my mind) completely bald. That hot summer morning I had prayed with him and read the Twenty-third Psalm. Toward evening, I went up again to the death ward¯for so everybody called it¯to see him again. Clearly the end was near. Although he had been given a sedative, he was entirely lucid. I put my left arm around his shoulder and together, face almost touching face, we prayed the Our Father. Then Albert’s eyes opened wider, as though he had seen something in my expression. “Oh,” he said, “Oh, don’t be afraid.” His body sagged back and he was dead. Stunned, I realized that, while I thought I was ministering to him, his last moment of life was expended in ministering to me.

There is another death that will not leave me. Charlie Williams was a deacon of St. John the Evangelist in Brooklyn. (We sometimes called the parish St. John the Mundane in order to distinguish it from St. John the Divine, the Episcopal cathedral up on Morningside Heights.) Charlie was an ever ebullient and sustaining presence through rough times. In the face of every difficulty, he had no doubt but that “Jesus going to see us through.” Then something went bad in his chest, and the doctors made medically erudite noises to cover their ignorance. I held his hand as he died a painful death at age forty-three. Through the blood that bubbled up from his hemorrhaging lungs he formed his last word¯very quietly, not complaining but deeply puzzled, he looked up at me and said, “Why?”

Between Albert’s calm assurance and Charlie’s puzzlement, who is to say which is the Christian way to die? I have been with others who screamed defiance, and some who screamed with pain, and many who just went to sleep. Typically today the patient is heavily sedated and plugged into sundry machines. One only knows that death has come when the beeping lines on the monitors go flat or the attending physician nods his head in acknowledgment of medicine’s defeat. It used to be that we accompanied sisters and brothers to their final encounter. Now we mostly sit by and wait. The last moment that we are really with them, and they with us, is often hours or even many days before they die. But medical technology notwithstanding, for each one of them, for each one of us, at some point “it” happens.

It has often been said that each death is unique, that each of us must die our own death. Enthusiasts such as Walt Whitman gild the inevitable. “Nothing can happen more beautiful than death,” he wrote in Leaves of Grass . In “Song of Myself” he trumpets: “Has anyone supposed it lucky to be born? / I hasten to inform him or her, it is just as lucky to die, and I know it.” Good for him. “Why fear death?” asked Charles Frohman as he went down with the sinking Lusitania . “Death is only a beautiful adventure.” Fare thee well, Mr. Frohman. If each life is unique, and it is, then it would seem to follow that each death is unique. I will not dispute the logic of that. And there is no doubt an element of adventure in moving into the unknown. But in my own experience of dying, it struck me as so very commonplace, even trite, that this life should end this way. Perhaps I should explain.

Several lawyers have told me that it would make a terrific malpractice suit. All I would have to do is make a deposition and then answer a few questions in court, if it ever came to trial, which it probably wouldn’t since the insurance companies would be eager to settle. It would be, I was assured, a very big settlement. The statute of limitations has not run out as of this writing. But I will not sue, mainly because it would somehow sully my gratitude for being returned from the jaws of death. Gratitude is too precious and too fragile to keep company with what looks suspiciously like revenge.

The stomach pains and intestinal cramps had been coming on for almost a year. My regular physician, a Park Avenue doctor of excellent reputation, had told me long ago how pleased he was with the new techniques for colonoscopy. It meant, he said, that none of his patients need die of colon cancer. His partner, the specialist in these matters, did one colonoscopy and, some weeks later, another. After each mildly painful probing up through the intestines, he was glad to tell me that there was nothing there. Then, on Sunday afternoon, January 10, 1993, about five o’clock, after four days of intense discomfort in which there was yet another probe and yet another x-ray, I was at home suddenly doubled over on the floor with nausea and pain. The sensation was of my stomach exploding.

My friend George Weigel was visiting and he phoned the doctor’s office, but the doctor was on vacation. The doctor covering for him listened to the symptoms and prescribed a powerful laxative. (I said that this story would smack of the commonplace.) Much later, other doctors said that the prescription might, more than possibly, have been fatal. They said they never heard of several colonoscopies not detecting a tumor, and shook their heads over a physician who would prescribe a laxative after being apprised of symptoms indicating something much more seriously wrong.

Weigel had the presence of mind to bundle me off¯pushing, pulling, half-carrying me¯to the nearest emergency room, which, fortunately, was only a block from the house. The place was crowded. I strongly recommend always having with you an aggressive friend or two when you go to a hospital and are really sick. A large and imperiously indifferent woman at the desk was not about to let anyone jump the line of waiting cases, relenting only when Weigel gave signs that he was not averse to the use of physical violence. She then sat me down to answer a long list of questions about symptoms and medical insurance, which I tried to answer until I fell off the chair in a faint, at which point she surmised she had an emergency on her hands. The experience so far did not instill confidence in the care I was likely to receive.

Very soon, however, I was flat on my back on a gurney, surrounded by tubes, machines, and technicians exhibiting their practiced display of frenetic precision, just like on television. The hospital’s chief surgeon, who happened to be on duty that night, ordered an x-ray that showed a large tumor in the colon and declared there was no time to lose. I was wheeled at great speed down the halls for an elevator to the operating room, only to discover the elevators were out of order. By then I had been sedated and was feeling no pain. In fact, I was somewhat giddy and recall trying to make a joke about the contrast between the high-tech medicine and the broken-down elevators. A guard showed up who said he knew how to get the number six elevator working, and then I was looking up at the white water-stained ceiling of the operating room, and then there was someone putting a mask over my face and telling me to breathe deeply, and then there was “Now I lay me down to sleep . . . ,” and then there was the next morning.

The operation took several hours and was an unspeakable mess. The tumor had expanded to rupture the intestine; blood, fecal matter, and guts all over the place. My stomach was sliced open from the rib cage down to the pubic area, then another slice five inches to the left from the navel for a temporary colostomy. I’ve noticed that in such cases the doctors always seem to say that the tumor was “as big as a grapefruit,” but my surgeon insists the blackish gray glob was the size of “a big apple.” After they had sewed me up, the hemorrhaging began, they knew not from where. Blood pressure collapsed and other vital signs began to fade. What to do? The surgeon advised my friend to call the immediate family and let them know I would likely not make it through the night. The doctors debated. To open me up all over again might kill me. On the other hand, if they didn’t find and stop the hemorrhaging I was surely dead.

Of course they went in again. The source of the effusion of blood was the spleen, “nicked,” as the surgeon said, in the ghastliness of the first surgery. Given the circumstances, I’m surprised that parts more vital were not nicked. The spleen removed and the blood flow stanched, they sewed me up again and waited to see if I would live. The particulars of that night, of course, I was told after the event. “It was an interesting case,” one doctor opined in a friendly manner. “It was as though you had been hit twice by a Mack truck going sixty miles an hour. I didn’t think you’d survive.”

My first clear memory is of the next morning, I don’t know what time. I am surrounded by doctors and technicians talking in a worried tone about why I am not coming to. I heard everything that was said and desperately wanted to respond, but I was locked into absolute immobility, incapable of moving an eyelash or twitching a toe. The sensation was that of being encased in marble; pink marble, I thought, such as is used for gravestones. The surgeon repeatedly urged me to move my thumb, but it was impossible. Then I heard, “The Cardinal is here.” It was my bishop, John Cardinal O’Connor. He spoke directly into my right ear, repeatedly calling my name. Then, “Richard, wriggle your nose.” It was a plea and a command, and I wanted to do it more urgently than anything I have ever wanted to do in my life. The trying, the sheer exercise of will to wriggle my nose, seemed to go on and on, and then I felt a twinge, no more than a fraction of a millimeter, and the Cardinal said, “He did it! He did it!” “I didn’t see anything,” said the surgeon. So I tried again, and I did it again, and everybody saw it, and the Cardinal and the doctors and the technicians all began to exclaim what a wonderful thing it was, as though one had risen from the dead.

The days in the intensive care unit was an experience familiar to anyone who has ever been there. I had never been there before, except to visit others, and that is nothing like being there. I was struck by my disposition of utter passivity. There was absolutely nothing I could do or wanted to do, except to lie there and let them do whatever they do in such a place. Indifferent to time, I neither knew nor cared whether it was night or day. I recall counting sixteen different tubes and other things plugged into my body before I stopped counting. From time to time, it seemed several times an hour but surely could not have been, a strange young woman with a brown wool hat and heavy gold necklace would come by and whisper, “I want blood.” She stuck in a needle and took blood, smiling mysteriously all the time. She could have said she wanted to cut off my right leg and I would probably have raised no objection. So busy was I with just being there, with one thought that was my one and every thought: “I almost died.”

Astonishment and passivity were strangely mixed. I confess to having thought of myself as a person very much in charge. Friends, meaning, I trust, no unkindness, had sometimes described me as a control freak. Now there was nothing to be done, nothing that I could do, except be there. Here comes a most curious part of the story, and readers may make of it what they will. Much has been written on “near death” experiences. I had always been skeptical of such tales. I am much less so now. I am inclined to think of it as a “near life” experience, and it happened this way.

It was a couple of days after leaving intensive care, and it was night. I could hear patients in adjoining rooms moaning and mumbling and occasionally calling out; the surrounding medical machines were pumping and sucking and bleeping as usual. Then, all of a sudden, I was jerked into an utterly lucid state of awareness. I was sitting up in the bed staring intently into the darkness, although in fact I knew my body was lying flat. What I was staring at was a color like blue and purple, and vaguely in the form of hanging drapery. By the drapery were two “presences.” I saw them and yet did not see them, and I cannot explain that. But they were there, and I knew that I was not tied to the bed. I was able and prepared to get up and go somewhere. And then the presences¯one or both of them, I do not know¯spoke. This I heard clearly. Not in an ordinary way, for I cannot remember anything about the voice. But the message was beyond mistaking: “Everything is ready now.”

That was it. They waited for a while, maybe for a minute. Whether they were waiting for a response or just waiting to see whether I had received the message, I don’t know. “Everything is ready now.” It was not in the form of a command, nor was it an invitation to do anything. They were just letting me know. Then they were gone, and I was again flat on my back with my mind racing wildly. I had an iron resolve to determine right then and there what had happened. Had I been dreaming? In no way. I was then and was now as lucid and wide awake as I had ever been in my life.

Tell me that I was dreaming and you might as well tell me that I was dreaming that I wrote the sentence before this one. Testing my awareness, I pinched myself hard, and ran through the multiplication tables, and recalled the birth dates of my seven brothers and sisters, and my wits were vibrantly about me. The whole thing had lasted three or four minutes, maybe less. I resolved at that moment that I would never, never let anything dissuade me from the reality of what had happened. Knowing myself, I expected I would later be inclined to doubt it. It was an experience as real, as powerfully confirmed by the senses, as anything I have ever known. That was some seven years ago. Since then I have not had a moment in which I was seriously tempted to think it did not happen. It happened¯as surely, as simply, as undeniably as it happened that I tied my shoelaces this morning. I could as well deny the one as deny the other, and were I to deny either I would surely be mad.

“Everything is ready now.” I would be thinking about that incessantly during the months of convalescence. My theological mind would immediately go to work on it. They were angels, of course. Angelos simply means “messenger.” There were no white robes or wings or anything of that sort. As I said, I did not see them in any ordinary sense. But there was a message; therefore there were messengers. Clearly, the message was that I could go somewhere with them. Not that I must go or should go, but simply that they were ready if I was. Go where? To God, or so it seemed. I understood that they were ready to get me ready to see God. It was obvious enough to me that I was not prepared, in my present physical and spiritual condition, for the beatific vision, for seeing God face to face. They were ready to get me ready. This comports with the doctrine of purgatory, that there is a process of purging and preparation to get us ready to meet God. I should say that their presence was entirely friendly. There was nothing sweet or cloying, and there was no urgency about it. It was as though they just wanted to let me know. The decision was mine as to when or whether I would take them up on the offer.

There is this about being really sick, you get an enormous amount of attention. I cannot say that I did not enjoy it. In the pain and the nausea and the boredom without end, there were times when I was content to lie back and enjoy the attention. It was a kind of compensation. Over these days there were hundreds of cards and letters and phone calls and, later, brief visits¯the last by people who sometimes betrayed the hope of having a final word with what they took to be their dying friend. Some of those who checked in I had not seen in years. Nor have I seen them since, so busy are we with our several busynesses. Sickness is an enforced pause for the counting up of our friends, and being grateful.

In all the cards and letters assuring me of prayer, and almost all did offer such assurance, there were notable differences. Catholics say they are “storming the gates of heaven” on your behalf, and have arranged to have Masses said. Evangelical Protestants are “lifting you up before the throne.” Mainline Protestants, Jews, and the unaffiliated let it go with a simple “I am praying for you,” or “You are in my prayers.” One gets the impression that Catholics and evangelicals are more aggressive on the prayer front.

Then there were longer letters laying out the case for my getting better. A friend who is a constitutional scholar at an Ivy League university wrote a virtual lawyer’s brief summing up the reasons for dying and the reasons for living, and came down strongly on the side of my living. It was very odd, because after that there were a number of similar letters, all arguing that I should stay around for a while and assuming that I was undecided about that. I was undecided. This struck me as strange: at the time of crisis and in the months of recovery following, I was never once afraid. I don’t claim it as a virtue; it was simply the fact. It had less to do with courage than with indifference. Maybe this is “holy indifference,” what the spiritual manuals describe as “a quality in a person’s love for God above all that excludes preferences for any person, object, or condition of life.” Aquinas, St. John of the Cross, and Ignatius Loyola all write at length about such holy indifference. All I know is that I was surprisingly indifferent to whether I would live or die. It probably had less to do with holiness than with my knowing that there was nothing I could do about it one way or the other.

On the other hand, there was the message: “Everything is ready now.” As though the decision were mine, to stay or to go. A friend who had written with his son the story of his son’s several years of waging a heroic battle against a horrific series of cancers sent me their book, inscribed with the admonition “to fight relentlessly for life.” It was very kind, but I was not at all disposed to fight. More to the point were those letters calmly laying out the reasons why it would be better for others, if not for me, were I to live rather than to die. Over the slow weeks and slower months of recovery, I gradually came to agree. But still very tentatively.

When I was recuperating at home and could take phone calls, those calls became a staple of everyday existence. There were dozens of calls daily; closer friends called every day. Somebody was always on call-waiting. I enjoyed it shamelessly. Although I was often too tired to talk, when I had the energy I related in detail, over and over again, every minuscule change in my condition. With a credible display of intense interest, people listened to the problems with colostomy bags and the latest wrinkle in controlling the nausea that came with chemotherapy. And always in my talking, I was on the edge of tears. I, who had seldom cried in my adult life, was regularly, and without embarrassment, blubbering. Not in sadness. Not at all. But in a kind of amazement that this had happened to me, and maybe I was going to die and maybe I was going to live, and it was all quite out of my control. That was it, I think: I was not in charge, and it was both strange and very good not to be in charge.

Tentatively, I say, I began to think that I might live. It was not a particularly joyful prospect. Everything was shrouded by the thought of death, that I had almost died, that I may still die, that everyone and everything is dying. As much as I was grateful for all the calls and letters, I harbored a secret resentment. These friends who said they were thinking about me and praying for me all the time, I knew they also went shopping and visited their children and tended to their businesses, and there were long times when they were not thinking about me at all. More important, they were forgetting the primordial, overwhelming, indomitable fact: we are dying! Why weren’t they as crushingly impressed by that fact as I was?

After a month or so, I could, with assistance, walk around the block. Shuffle is the more accurate term, irrationally fearing with every step that my stomach would rip open again. I have lived in New York almost forty years and have always been a fierce chauvinist about the place. When you’re tired of London, you’re tired of life, said Dr. Johnson. I had always thought that about New York, where there is more terror and tenderness per square foot than any place in the world. I embraced all the clichés about the place, the palpable vitality of its streets, the electricity in the air, and so forth and so on. Shuffling around the block and then, later, around several blocks, I was tired of it. Death was everywhere. The children at the playground at 19th Street and Second Avenue I saw as corpses covered with putrefying skin. The bright young model prancing up Park Avenue with her portfolio under her arm and dreaming of the success she is to be, doesn’t she know she’s going to die, that she’s already dying? I wanted to cry out to everybody and everything, “Don’t you know what’s happening?” But I didn’t. Let them be in their innocence and ignorance. It didn’t matter. Nothing mattered.

Surprising to me, and to others, I did what had to be done with my work. I read manuscripts, wrote my columns, made editorial decisions, but all listlessly. It didn’t really matter. After some time, I could shuffle the few blocks to the church and say Mass. At the altar, I cried a lot, and hoped the people didn’t notice. To think that I’m really here after all, I thought, at the altar, at the axis mundi , the center of life. And of death. I would be helped back to the house, and days beyond numbering I would simply lie on the sofa looking out at the back yard. That birch tree, which every winter looked as dead as dead could be, was budding again. Would I be here to see it in full leaf, to see its leaves fall in the autumn? Never mind. It doesn’t matter.

When I was a young man a parishioner told me, “Do all your praying before you get really sick. When you’re sick you can’t really pray.” She was right, at least in largest part. Being really sick¯vomiting, and worrying about what will show up on the next blood test, and trying to ignore the pain at three o’clock in the morning¯is a full-time job. At best, you want to recede into relatively painless passivity, and listen to your older sister reading Willa Cather, as my sister read to me. During those long nights, My Antonia , Death Comes for the Archbishop , Shadows on the Rock , and at those times I could have wished it to go on and on. Not that it mattered, but it was ever so pleasant being ever so pampered.

People are different around the very sick, especially when they think they may be dying. In the hospital, bishops came to visit and knelt by my bedside, asking for a blessing. A Jewish doctor, professing himself an atheist, asked for my prayers with embarrassed urgency. His wife had cancer, he explained, “And you know about that now.” Call it primitive instinct or spiritual insight, but there is an aura about the sick and dying. They have crossed a line into a precinct others do not know. It is the aura of redemptive suffering, of suffering “offered up” on behalf of others, because there is nothing else to be done with it and you have to do something with it. The point is obvious but it impressed me nonetheless: when you are really sick it is impossible to imagine what it is like to be really well; and when you are well it is almost impossible to remember what it was like to be really sick. They are different precincts.

I had lost nearly fifty pounds and was greatly weakened. There was still another major surgery to come, to reverse the colostomy. You don’t want to know the details. It was not the most dangerous surgery, but it was the third Mack truck, and for a long time afterward I barely had strength to lift my hand. Then, step by almost imperceptible step, I was recovering and dared to hope that I would be well again, that I would stride down the street again, that I would take on new projects again. Very little things stand out like luminous signposts. The first time I was able to take a shower by myself. It was dying and rising again in baptismal flood. When one day I was sent home from the hospital after another round of tests, I was told that, if I did not urinate by five o’clock, I should come back to the emergency room and someone would put the catheter back in. My heart sank. It was quite irrational, but going back to the emergency room would have been like recapitulating the entire ordeal of these last several months. I could not endure the thought. When at four o’clock I peed a strong triumphant pee, my heart was lifted on high, and with tears of gratitude I began to sing with feeble voice a Te Deum. I thought, “I am going to get better.” And I allowed myself, ever so tentatively, to be glad.

That was seven years ago. I feel very well now. They tell me I might be around for another twenty years or so. Medical science, perhaps arbitrarily, says five years is the point of complete recovery when you are reassigned to your age slot on the actuarial chart. But just to be safe, the tests continue on a regular basis. Next Monday we get the latest report on the CEA (Carcinoembryonic Antigen), the blood indicator of cancerous activity, although the doctor says the test is really not necessary. But I think I am well now. It took a long time after the surgeries, almost two years, before the day came when I suddenly realized that the controlling thought that day had not been the thought of death. And now, in writing this little essay, it all comes back. I remember where I have been, and where I will be again, and where we will all be.

There is nothing that remarkable in my story, except that we are all unique in our living and dying. Early on in my illness a friend gave me John Donne’s wondrous Devotions Upon Emergent Occasions . The Devotions were written a year after Donne had almost died, and then lingered for months by death’s door. He writes, “Though I may have seniors, others may be elder than I, yet I have proceeded apace in a good university, and gone a great way in a little time, by the furtherance of a vehement fever.” So I too have been to a good university, and what I have learned, what I have learned most importantly, is that, in living and in dying, everything is ready now.